Huang Shih-Yin, Jung Shih-Ming, Ng Koon-Kwan, Chang Yu-Chen, Lai Chyong-Huey
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University, 5 Fu-Shin St., Kueishan, Taoyuan 333, Taiwan.
Gynecol Oncol. 2005 May;97(2):652-5. doi: 10.1016/j.ygyno.2005.01.035.
There have been several reports about successful fertility-preserving treatment of endometrial carcinoma with subsequent pregnancy. However, conservative hormonal treatment for early-stage endometrial cancer still entails some risk.
We present a 36-year-old nulliparous woman, initially diagnosed as clinical stage IA, grade 1 endometrial adenocarcinoma, receiving 6-month conservative treatment with remission achieved at 4 months from diagnosis. Recurrence at the endometrium was documented at the end of treatment. She underwent a definitive surgery including total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. The final pathology revealed well-differentiated endometrioid adenocarcinoma with inner one-third myometrial invasion and right ovarian metastasis.
This case report signals a warning that negative preoperative imaging studies are not reassuring for a relapsing low-grade, early-stage endometrial carcinoma failing conservative treatment.
已有多篇关于子宫内膜癌成功进行生育保留治疗并随后妊娠的报道。然而，早期子宫内膜癌的保守激素治疗仍存在一定风险。
我们报告一名36岁未生育女性，最初诊断为临床IA期、1级子宫内膜腺癌，接受了6个月的保守治疗，诊断后4个月病情缓解。治疗结束时记录到子宫内膜复发。她接受了包括全子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结清扫术在内的确定性手术。最终病理显示为高分化子宫内膜样腺癌，肌层内三分之一浸润，右侧卵巢转移。
本病例报告警示，术前影像学检查结果为阴性并不能让人放心，对于保守治疗失败的复发性低级别、早期子宫内膜癌来说并非如此。
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